On the pulse

At the RCN Congress in Liverpool this week, some of the most pressing issues facing the nursing profession were on the agenda. In particular, two stories covered by Nursing Times highlighted the need for greater awareness of the value of some nursing roles.

DH exploring national pay increment freeze

The Department of Health is to examine introducing a national freeze in annual pay increments affecting more than a million NHS staff.

Director general of NHS finance, performance and operations David Flory spoke to Nursing Times’ sister magazine HSJ in the wake of last week’s spending review, which left the NHS with a real terms increase of 0.1 per cent a year.

Asked if the tight settlement now made a pay increment freeze more pressing, Mr Flory said: “The pay drift around increments is a significant cost pressure. In the end, within our resource limit, there is a trade-off between increases in pay and number of jobs.”

From April next year, NHS staff, in common with other public sector employees, will not receive a cost of living pay rise. However, Agenda for Change pay increments – worth an average 2.5 per cent a year - are not affected.

Approximately 70 per cent of staff on the AfC pay deal receive such increments at an estimated cost of almost £1bn a year across the NHS.

Last month Nursing Times and HSJ reported that foundation trusts were drawing up plans to freeze increments. Speaking this week, Mr Flory said the department would not stand in their way.

However, rather than going it alone, foundations are hoping the DH would implement a national freeze. Asked if the DH would consider such a move, Mr Flory said: “It’s clearly an issue we’re thinking about. As we move forward we will discuss that.”

Unison senior national officer for health Mike Jackson said the suggestion was “deplorable”.

He said: “At a time when we have a pay freeze, the increments are the one thing that mitigates [that]”. He pointed out that at an average 2.5 per cent increase a year, pay increments were currently not even keeping up with inflation, which is running at 3.1 per cent.

Mr Jackson added that although a number of foundation trusts had proposed increment freezes to their local staff representatives, none of them had been able to offer guarantees against redundancies in exchange.

By contrast, Royal College of Nursing head of employment relations Josie Irwin suggested her union might be more accommodating if the DH went ahead with the freeze. She told Nursing Times: “We would be naive if we weren’t anticipating serious discussions.”

“There are some very difficult questions that have to be faced in terms of balancing pay and jobs. We want to have those conversations because we believe trade unions are part of the solution and we want to find an approach that safe guards our members but is not at the dis-benefit of patients.”

She said the introduction of a national framework for freezing increments would be preferable to local increment freezes, which could lead to a return of unfair pay inequalities across the NHS.

Asked if the RCN might support an increment freeze if couched in terms of job protection Ms Irwin said: “I don’t even think it’s as strong as ‘may be’. But there is a discussion to have about a problem everyone faces.

“It may be we can find a way through that doesn’t have to mean additional pay restraint.”

She said that while discussions would inevitably go on around the balance between “pay and jobs”, arguments in favour of an increment freeze would need to be weighed against “very low” level to which NHS staff morale had now fallen.

Concerns about the NHS funding settlement came despite chancellor George Osborne claiming he had “protected” the NHS with a headline real terms increase of 0.1 per cent a year.

The claim is based on comparison with GDP inflation, currently running at 1.9 per cent and significantly lower than the consumer price index measure of 3.1 per cent.

However, the spending review also announced a cumulative £3.8bn transfer over four years from the NHS’s capital budget to fund adult social care. After that transfer – which will peak at £1.1bn in 2013-14 – the average real terms change falls to minus 0.1 per cent a year over the four year period (see graph).

Mr Flory said the transfer from the NHS budget had been necessary due to the 26 per cent real terms cut to local authority budgets.

He argued that, as the spending would be channelled through the “statutory structures of the NHS”, the NHS would be “at the table” working out the best way to spend the money and therefore reducing the knock-on effects on the NHS, such as delayed discharge.

A snapshot poll of 1,250 Nursing Times readers, carried out online last week, found 65 per cent thought people climbed the incremental pay scale without their skills being properly scrutinised.

The survey also showed a reduction since a similar poll in July on the number of nurses prepared to sacrifice a pay rise in exchange for their job being protected – down from 44 per cent to 36 per cent.

There was a slight increase in the number of nurses who said they would consider industrial action if annual increment progression was blocked – up from 38 per cent to 42 per cent.

Senior NHS managers are being asked to sign a declaration drafted by NHS Employers setting out their reasons for supporting a two year freeze in staff pay increments in exchange for “no compulsory redundancy” guarantees.

What is your position on Christmas? Are you going to spend too much on presents, have another mince pie, maybe a glass of wine or two and get back into the gym after New Year, assuming you can see your feet to tie your unused trainers?

Readers' comments (74)

NO I WOULD NOT. i AM ABSOLUTELY DISGUSTED HOW WE ARE BEING TREATED I NEVER BELIEVED THE GOVERNMENT AND MANAGEMENT WOULD SINK THIS LOW. HOWEVER I SHOULD NOT BE SURPRISED HAVING BEEN A NURSE FOR 33 YEARS. We have already been subjected to working unsocial hours for little reward comparfed to other public sector workers and further we have shortened our live expectancy because of these hours we have worked against our natural circadian rhythm. I would never advise anyone enter the nursing profession for your devotion to your patients and natural caring nature is continually taken advantage of. the government and management prey on our good nature and willingness and i believe a they are legalised criminals and blackmailers. I f i had my time again or was 10 years younger I would choose another carrer one where I am respected and receive proper renumeration. My only gratitude is the wonderful patient's I have been privelidged to meet and care for.

Quite right Irene, how dare the RCN and David Flory talk as though a freeze would be acceptable. I don't care what the climate is they cant seriously expect sympathy from us for the wage bill arising of AfC increments. This scheme was agreed long ago after it became a necessity to right pay after being sold down the river in the nineties by the tories. give it with one hand and take it away with the other - TWICE in my 32 two years service NO NO NO - your not having it this time.

before they even consider taking away what little extra we deserve which is paltry i might add,why dont they focus on these highly paid bankers and politicians with their bonuses and expenses and anyone else who earns this ludicrous amount. it makes me sick.

I am disgudted that the governenment see to think they can walk all over the nursing profession, but what saddens me more is that the RCN are happy to accept this, they seem content to roll over and let the government tickle thier tummies rather than stand up and fight for those they represent. I think that it's about time we all stood up to those in power and make them realise we will no longer be pushed around!

This makes me sick. They always have to go for the NHS, police have cuts but they seem to still be paying their bonus's. My sister works for the CSA and has just recieved a work performance related bonus something a lot of other public sector workers get however to my knowledge the NHS has never had. Surely the bonus schemes should go long before pay increments that are not even in line with inflation anyway. Why oh why RCN are you suggesting you may support this????

Why do we have to be penalised yet again? Agenda for change has been such a downgrading exercise anyway. If AFC salaries are frozen then we get a double pay cut as I beleive we will not get an annual inflation rise either. We will spend less, businesses with go bust.
What about the doctors? They are not on AFC. Will they be forced to take a pay cut? It is partly the fault of the Dr's that we are in this mess anyway, as they cleverly negotiated a huge increase in salary. GP's are crippling the NHS and now we want to hand them even more power than they had before. The last government missed all this and we have to pay. I have no faith in this government either. (Note the small g! No conficendence in making them capital!)

Yes!
But:
I want to be able to take meal breaks while on duty and leave on time.
I don't want to be pressured into working on my days off with little hope of time back (or even a thank you)
I want to be paid for the many overtime hours I give to the NHS for free.
I want to see equality across the public sector and the constant attack on nurses.
I want to see true change management and proper effeciency - not just clinical staff reduction.
There needs to be sweeping change to the tax laws so that the rich actually pay tax and don't legally dodge it (and that probably includes MPs)
Benefit cheats must be stopped and the system truly tightened up before punishing everyone just to reduce the payouts.
When all that has been accomplished then I will take a pay cut (let's not play with words a freeze is a cut with the increases inpension contribution, freeze of cost of living and the constant increase in basic daily living items).
Lets see the RCN act on that - act for your members, be a union and not an apology for poor goverments of whatever persuasion.

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